EMR的横结肠息肉

                               
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A 71 year old man with history of a stroke 11 years ago (good recovery) and peripheral vascular disease (smoker, previous femoral cross over graft 3 years ago) attended for a colonoscopy under the UK Bowel Cancer Screening Programme. He is normally on aspirin and warfarin. The latter was stopped 5 days prior to the procedure and INR on the day was 0.9.

At the index colonoscopy, 6 polyps were found and four of these were removed. Two polyps (both 1- 1.5cm) in the left colon were left for another day. The video shows the EMR of the trickiest polyp which was situated in the distal transverse colon.

The colonoscopy went uneventfully but whilst in the recovery area, the patient developed weakness in his left arm and leg and had left homonymous hemianopia. The weakness resolved quickly but he still had the hemianopia the next day. CT scan of the head showed a new right occipital infarct.